Active NPI
Helen V Fazylova, DMD
- General Practice Dentistry
- Biloxi, MS
National Provider Identifier
1629207196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3576-10
- Practice address
- 15816 Lemoyne Blvd
Suite a
Biloxi, MS 39532-4019 - Phone
- (228) 207-0046
- Fax
- (228) 207-0047
- NPI assigned
- Jul 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401412901 | VA | |
| General Practice Dentistry | 1223G0001X | 3576-10 | MS | Primary |
Addresses
Primary practice location
15816 Lemoyne Blvd
Suite a
Biloxi, MS 39532-4019
Mailing address
15816 Lemoyne Blvd Ste a
Biloxi, MS 39532-4048
Phone (228) 207-0046
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08284523 | Medicaid | MS |
Other names 1
- Helen V Cardaciotto
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3576-10 | MS | MD | General Practice Dentistry |
| 0401412901 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Helen Cardaciotto, DMD, Family Dentistry, LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Biloxi, MS
- NPI 1679828149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625702400000",
"number": "1629207196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15816 LEMOYNE BLVD STE A",
"city": "BILOXI",
"state": "MS",
"postal_code": "395324048",
"telephone_number": "228-207-0046",
"fax_number": "228-207-0047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15816 LEMOYNE BLVD",
"address_2": "SUITE A",
"city": "BILOXI",
"state": "MS",
"postal_code": "395324019",
"telephone_number": "228-207-0046",
"fax_number": "228-207-0047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZYLOVA",
"first_name": "HELEN",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-06",
"last_updated": "2021-07-08",
"certification_date": "2021-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401412901",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "3576-10",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08284523",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "HELEN",
"last_name": "CARDACIOTTO",
"middle_name": "V",
"credential": "DMD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.